Effective care and treatment of chronic wounds of the lower extremity, requires experience, patience and the proper wound care products and devices. Podiatrists are prepared and equipped to provide the best in chronic wound care. Special emphasis is placed on the care of chronic or difficult to heal wounds of the lower limb. These wounds include: diabetic neurotrophic plantar ulceration, venous stasis ulcers, ischemic ulcers and pre-gangrenous changes, decubitus ulcers and wounds resulting from trauma or infection, causing significant tissue destruction.

Our wound care team obtains a complete patient history and assesses the neurologic, vascular and musculoskeletal systems to better understand the nature of the wound. In the past, wound care treatment consisted of tissue debridement with a small variety of wound dressing materials. Today, products are not only designed to protect the wound and reduce infection, but may be biologically active to stimulate cellular growth at the wound site.

Once a wound has been cleared of infection and initial debridement is completed, it might require protection from weight bearing and shoe irritation. This may involve the use of Unna boot application, surgical shoes, removable short-leg cast or the application of a total-contact cast.

Some chronic wounds may require "jump-starting" of the normal regenerative process. This may involve the use of a product like Promogran Matrix wound dressing. This special dressing contains combinations of collagen and oxidized regenerated cellulose. It inhibits excessive wound site proteases, allowing growth factors to go to work promoting cell proliferation and tissue synthesis. Regranex Gel, a substance containing recombinant human platelet derived growth factor stops abruptly. This topical application serves to supplement the wound healing activity started by other wound dressing materials and mechanical debridement of the wound. The Graft Jacket is also being used to aid in the closure of foot ulcers with significant depth and width. This material is described as an acellular human skin matrix void. It is reconstituted with normal saline prior to application at the wound site.

Other wounds lack adequate skin closure over a granulating wound bed and benefit from tissue-engineered products containing living skin cells. These products include Apligraf, a bilayered living skin substitute that contains both dermis and epidermis. Dermagraft, another product, consists of cultured, fully human dermis. Both of these skin substitute products contain living cells derived from neonatal foreskin.

The "Wound -Vac" product is a wound dressing set-up that creates a negative pressure environment over the wound to stimulate increased local circulation.

Your podiatrist has many options in their ability to create the best wound healing scenario. Please contact us to answer any wound questions that you may have.